Renovascular disease (RVD) is an important cause of severe hypertension in children. It serves as a causative factor in 5–10 % of all cases of childhood hypertension. It is a potentially treatable cause of hypertension and is often caused by renal artery stenosis (RAS). However, it is difficult to diagnose. Renovascular doppler ultrasonography is the screen test. But it depends on the clinical experience of the radiologist. Here we discuss a hypertensive patient with vesicoureteral reflux and renal artery stenosis.

Material and methods:

The patient was referred to our hospital due to headache and hypertension at the age of 9 years. He was not obese or over-weight. Investigations revealed reflux nephropathy with normal serum creatinine without proteinuria. Doppler USG was normal. He underwent anti-reflux surgery and was given dual antihypertensive treatment. The patient, who was followed up to the age of 15 years by normotensive, was reevaluated because of the lack of blood pressure control after weight gain. Repeated serum renin and aldosterone levels are high. Doppler USG was repeated and blood flow to the left renal artery was decreased which was suspicious with renal artery stenosis. It was confirmed with CT angiography. The narrow segment was dilated by balloon angiography. At the last follow-up, his blood pressure was under control with anti-hypertensive medications

Results:

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Conclusions:

Hypertension may be long term complication of renal scar associated with vesicoureteral reflux. Reflux nephropathy and renovascular disorders are rarely found together at the same person. So, even if there are underlying urological problems, the renovascular disorders should be investigated in children uncontrolled hypertension.